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Posting Date: 03/27/2025
Ensure Accurate Provider Enrollment Information on File
Ensure Accurate Provider Enrollment Information on File ATTENTION: Claims and Provider Enrollment Verify that accurate provider enrollment information is on file with Medicare. Are you familiar with the details identified in the PECOS system [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction K HHH Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Home Health Medical Necessity N/A 55H3V– The documentation did not support the medical [...]
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Posting Date: 03/27/2025
Understanding the Approval Recommendation Process for Certified Providers
Understanding the Approval Recommendation Process for Certified Providers The certified provider completes and submits a CMS-855 enrollment application and all supporting documentation to its MAC, including any state require documentation [...]
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Posting Date: 02/26/2024
Ambulance Duplicate Claim Denials
Ambulance Duplicate Claim Denials Duplicate trips may be reported on the same claim if the ZIP code for the point of pick-up for both trips is the same. If separate claims are submitted for the same beneficiary on the same day with the same [...]
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Posting Date: 01/31/2015
Ambulance Transports Included in SNF Consolidated Billing
Ambulance Transports Included in SNF Consolidated Billing Transport Description Medical Necessity Met Ambulance Billing Modifiers and Other Considerations Who is Responsible for Payment? Reference(s) SNF to [...]
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Posting Date: 03/27/2025
Top JK Part B Claim Errors are Available
Top JK Part B Claim Errors are Available We conduct a comprehensive data analysis on a quarterly basis to update and disseminate the latest insights on the most common claim errors. This initiative provides: Claim Error Reason Code [...]
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